Right now, doctors are like piece-meal, freelance contract workers. They only make a decent living if 1) they see a LOT of customers and 2) the products and services they sell are expensive. Hence, it behooves them to be listed in as many private insurance networks as possible since that’s how they’ll get their large customer base. (Having worked in a privately-run hospital, a private health clinic, and a private physical therapy clinic, I got to work with these doctors and various health practioners first-hand.)
There is no incentive whatsover to reduce health care costs. Requiring everyone to have some sort of health insurance — whether private or public — is fine and all, but not if the health insurance won’t pay for the requested health product or service because of 1) denial of coverage (the private option) or 2) rationing (the likely public option) because it COSTS TOO DAMN MUCH and will bankrupt 1) the company or 2) the country. respectively.
Either version — if you’re unemployed/underemployed and/or with a pre-existing condition — SUCKS.
Simple supply and demand — the demand for health services will not go away. Why? Because, eventually, we will all get very very sick and then we will all die but try REALLY HARD not to. Inelastic demand.
It’s hardly likely the pharmaceutical and medtech companies will reduce their costs because they’re for-profit, market-driven industries. FREE-MARKET CAPITALISM, YO.
But if the DOCTORS didn’t write a gazillion scrips and order a gazillion expensive tests, just to get paid a decent wage to 1) pay for their medical school loans , 2) pay for the overhead of their leased offices, and 3) pay for their malpractice insurance, then the lowered demand for these pharma/medtech products might –just might — lower the costs.
But what would change the doctors need to write and order those scrips and tests?
If they were paid not by the “fee for service” freelance, piece-meal worker fashion but as a salaried employee of a LARGE ENOUGH non-profit entity.
The the majority of doctors who have this pay-structure are in the military. (By the way, I find it funny that it seems that nobody — on the left or right — ever mentions that, since no one ever disputes whether military medicine is socialist/ communist/ unAmerican/ inferior.) What we need is a CIVILIAN version of the voluntary military medical corps: federally-funded medical schools (in which the federal government picks up the ENTIRE tuition tab through scholarships and grants, to ensure high enrollment), with newly minted doctors giving at least four years of public service, giving medical care in federally-funded county/city public clinics and hospitals. (After four years — just like the military — they can re-enlist or move on to other institutions… even private ones, if they so choose.)
Imagine Parkland Hospital, with salaried doctors and increased revenue streams, who happen to be a branch of a larger network of nation-wide public medical institutions of education and patient care. In the military, they’re called hospitals/ clinics on base or on post. In the civilian world — well, we can call it something. “Heal for America”, maybe?
And just like civilian health care institutions do co-exist with military, privately-run institutions can certainly co-exist with public.
Seriously. If the folks on Capital Hill — whether Democrat, Republican, Libertarian, or Martian — are serious about lowering the cost of health care so that EVERYBODY can afford it (since EVERYBODY will need it, sooner or later), then something like a vibrant, viable “Heal for America” needs to be on the table.
But knowing the inertia of political will, I doubt it.